Provider Demographics
NPI:1972831949
Name:WITT, CAROL A (CAROL WITT)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:WITT
Suffix:
Gender:F
Credentials:CAROL WITT
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:A
Other - Last Name:TABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CAROL WITT
Mailing Address - Street 1:560 RAYFORD RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1920
Mailing Address - Country:US
Mailing Address - Phone:281-298-0040
Mailing Address - Fax:281-298-0045
Practice Address - Street 1:560 RAYFORD RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1920
Practice Address - Country:US
Practice Address - Phone:281-298-0040
Practice Address - Fax:281-298-0045
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42689183500000X
MN112883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist